Stanje zdravstvenog sistema Republike Srbije u periodu 2004-2012. godine

Introduction The backbone of Serbian health system forms the public healthcare provider network with 355 institutions and around 112,000 employees, owned and controlled by the Ministry of Health and financed mainly by the Republican Health Insurance Fund. The law recognizes private practice that was not included, till recently, in the public funding scheme. New Health Insurance Law (2005) decreased the number of entitlements in the basic health service package. It abolished the right to dental health care for adults (exceptions are: children, older than 65, pregnant women and emergency cases) as well as the right to compensate travel expenses. The aim of this study was to evaluate the effects of health care system of the Republic of Serbia and indicate parameters that determine the state of health of the population, on the ground of data obtained by the Institute of Public Health of Serbia. Results In the period 2004-2012, cardiovascular diseases represented the main cause of illness in Serbia (50%). In 2012 digestive system diseases were on the second place. Neoplasm and nervous system diseases were on the third place. From 2007 to 2012 there was slight decline in the birth rate and number of deaths, but the death rate increased from 13.9 to 14.2. Health care system in Serbia is funded through the combination of public finances and private contributions. Primary care is provided in 158 health care centres and health care stations, secondary and tertiary care services are offered in general hospitals, specialized hospitals, clinics, clinico-hospital centers and clinical centres. Conclusion A significant but not satisfactory progress has been achieved in the field of health status indicators as the most important outcome of the final performance of the health system. The transition of public health care system in Serbia since the communist period to present and slow integration with European Union is unfinished process.Uvod Osnovicu zdravstvenog sistema Republike Srbije čini zdravstvena mreža od 355 državnih zdravstvenih ustanova i oko 112.000 zaposlenih koji su pod kontrolom Ministarstva zdravlja, a finansiraju se preko Republičkog fonda zdravstvenog osiguranja. Zakon poznaje i privatni sektor, koji doskora nije bio uključen u shemu javnog finansiranja. Zakon o zdravstvenom osiguranju iz 2005. godine smanjio je prava u osnovnom zakonu zdravstvenih usluga i ukinuo pravo na stomatološku zdravstvenu zaštitu (s izuzetkom dece, osoba starijih od 65 godina, trudnica i hitnih slučajeva), odnosno pravo na naknadu putnih troškova u vezi s ostvarivanjem prava na zdravstvenu zaštitu. Cilj ovog rada je bio da se na osnovu podataka Instituta za javno zdravlje Srbije 'Dr Milan Jovanović Batut' procene efekti zdravstvenog sistema Republike Srbije i ukaže na parametre ovoga sistema koji određuju stanje zdravlja stanovništva. Rezultati Od 2004. do 2012. godine kardiovaskularne bolesti su bila najčešća oboljenja u Srbiji (50%). U 2012. godini bolesti digestivnog sistema bile su na drugom mestu. Na trećem mestu su maligne i bolesti nervnog sistema. U periodu 2007-2012. zabeležen je i blag pad nataliteta, smanjio se i broj smrtnih slučajeva, ali je stopa mortaliteta porasla sa 13,9 na 14,2. Sistem zdravstvene zaštite u Srbiji se finansira kroz kombinaciju državnih finansija i privatnih doprinosa. Primarna zdravstvena zaštita se odvija u 158 domova zdravlja, zdravstvenih stanica i ambulanti, a sekundarne i tercijarne službe rade u opštim i specijalnim bolnicama, institucijama, klinikama i kliničko- bolničkim centrima. Zaključak Značajan, ali nedovoljan, napredak postignut je u oblasti pokazatelja zdravstvenog stanja, kao najvažnijeg konačnog ishoda učinka zdravstvenog sistema. Tranzicija državnog sistema zdravstvene zaštite u Srbiji od komunističkog perioda do danas i usporeno integrisanje s Evropskom Unijom je nedovršen proces

Protective effects of carbonyl iron against multiple low-dose streptozotocin-induced diabetes in rodents.

Particulate adjuvants have shown increasing promise as effective, safe, and durable agents for the stimulation of immunity, or alternatively, the suppression of autoimmunity. Here we examined the potential of the adjuvant carbonyl iron (CI) for the modulation of organ-specific autoimmune disease-type 1 diabetes (T1D). T1D was induced by multiple low doses of streptozotocin (MLDS) that initiates beta cell death and triggers immune cell infiltration into the pancreatic islets. The results of this study indicate that the single in vivo application of CI to MLDS-treated DA rats, CBA/H mice, or C57BL/6 mice successfully counteracted the development of insulitis and hyperglycemia. The protective action was obtained either when CI was applied 7 days before, simultaneously with the first dose of streptozotocin, or 1 day after MLDS treatment. Ex vivo cell analysis of C57BL/6 mice showed that CI treatment reduced the proportion of proinflammatory F4/80+ CD40+ M1 macrophages and activated T lymphocytes in the spleen. Moreover, the treatment down-regulated the number of inflammatory CD4+ IFN-γ+ cells in pancreatic lymph nodes, Peyer's patches, and pancreas-infiltrating mononuclear cells, while simultaneously potentiating proportion of CD4+ IL17+ cells. The regulatory arm of the immune system represented by CD3+ NK1.1+ (NKT) and CD4+ CD25+ FoxP3+ regulatory T cells was potentiated after CI treatment. In vitro analysis showed that CI down-regulated CD40 and CD80 expression on dendritic cells thus probably interfering with their antigen-presenting ability. In conclusion, particulate adjuvant CI seems to suppress the activation of the innate immune response, which further affects the adaptive immune response directed toward pancreatic beta cells

Navike u ishrani kod osoba s poremećajem iz spektra autizma

Здраве навике у исхрани су један од есенцијалних фактора адекватног развијања детета. Оне се формирају од најранијег узраста, усавршавају се и трају током живота. Развој ових навика код деце типичног развоја пролази кроз одређене фазе и при томе се и родитељи и дете сусрећу са новим изазовима, које у извесном временском периоду превазилазе. Код деце с поремећајем из спектра аутизма, овај процес има идентичне фазе, али се јављају изазови који могу да перзистирају током читавог живота. Тада настаје стрес и исфрустрираност, како за децу са поремећајем из спектра аутизма, тако и за њихове родитеље. Циљ овог рада је да се прегледом доступне литературе издвоје и анализирају радови чији су предмет истраживања навике и проблеми у исхрани код деце и одраслих са поремећајем из спектра аутизма, као и интервенције којим се успешно делује на те проблеме. Претрага литературе вршена је уз помоћ Google Scholar-а. Добијени резултати показују да мајке деце са поремећајем из спектра аутизма пријављују потешкоће, које се најчешће односе на избегавање хране због текстуре, амбалаже, укуса, мириса или пак на приврженост намирницама које нису довољно хранљиве. Узрок томе су и проблеми сензорне обраде, проблеми са гастроинтестиналним трактом, али и околина која може поспешити или умањити ове потешкоће. Са потешкоћама се перзистентно суочавају и одрасле особе са поремећајем из спектра аутизма, иако неке од њих успевају да их превазиђу уз помоћ породице, пријатеља или процеса осамостаљивања. Такође, у раду је приказан и одређен број интервенција које су се показале као успешне у побољшању исхране код деце са поремећајем из спектра аутизма, као што су обуке родитеља, EAT UP интервенција и метод давања низа јасних инструкција за које постоји висока вероватноћа да ће их испитаник реализовати. Благовремено откривање тешкоћа у храњењу и разлога који до тих тешкоћа доводе, могу омогућити да родитељи и стручњаци заједно дођу до најоптималнијег решења, које неће бити стресно ни по дете ни по мајку, односно особу која о детету брине и која га храни.Healthy eating habits is one of the most important factors in child’s development. These habits are formed in toddlerhood and last a lifetime. Development of these habits in typically developing children undergoes different phases, each bringing new challenges to children and their parents. In children with autism, this process has these identical phases, but additional challenges are met that can last their whole lifetime. When children with autism and their parents are unable to overcome such challenges they grow frustrated and stressed. The aim of this work is to, through available resources, specify and analyze the researches on eating habits and problems in children and adults with autism spectrum disorder, as well as the intervention that can successfully help in dealing with these issues. Google Scholar was used to search for the appropriate research papers. Final results show that the mothers of children with autism report difficulties, most frequently in the children’ avoidance of certain foods due to their texture, packaging, taste or smell, and in children’ choice of foods with poor nutritional qualities. Some of the main causes for these difficulties are sensory experiences of food, problems with gastrointestinal tract, as well as the environment, which can either reinforce of weaken these difficulties. Similar difficulties are also encountered by adults with autism, although some of them manage to overcome them with the help of their families, friends, and individualization. In addition to this, this work depicts a number of interventions that proved successful in the promotion of healthy eating habits in children with autism spectrum disorder, such as appropriate training of parents, EAT UP intervention and giving high-probability instructional sequence. Timely discovery of eating difficulties enable parents and experts to find the most suitable solutions that will not be too stressful for the child or the mother, or the caretaker

Navike u ishrani kod osoba s poremećajem iz spektra autizma

Здраве навике у исхрани су један од есенцијалних фактора адекватног развијања детета. Оне се формирају од најранијег узраста, усавршавају се и трају током живота. Развој ових навика код деце типичног развоја пролази кроз одређене фазе и при томе се и родитељи и дете сусрећу са новим изазовима, које у извесном временском периоду превазилазе. Код деце с поремећајем из спектра аутизма, овај процес има идентичне фазе, али се јављају изазови који могу да перзистирају током читавог живота. Тада настаје стрес и исфрустрираност, како за децу са поремећајем из спектра аутизма, тако и за њихове родитеље. Циљ овог рада је да се прегледом доступне литературе издвоје и анализирају радови чији су предмет истраживања навике и проблеми у исхрани код деце и одраслих са поремећајем из спектра аутизма, као и интервенције којим се успешно делује на те проблеме. Претрага литературе вршена је уз помоћ Google Scholar-а. Добијени резултати показују да мајке деце са поремећајем из спектра аутизма пријављују потешкоће, које се најчешће односе на избегавање хране због текстуре, амбалаже, укуса, мириса или пак на приврженост намирницама које нису довољно хранљиве. Узрок томе су и проблеми сензорне обраде, проблеми са гастроинтестиналним трактом, али и околина која може поспешити или умањити ове потешкоће. Са потешкоћама се перзистентно суочавају и одрасле особе са поремећајем из спектра аутизма, иако неке од њих успевају да их превазиђу уз помоћ породице, пријатеља или процеса осамостаљивања. Такође, у раду је приказан и одређен број интервенција које су се показале као успешне у побољшању исхране код деце са поремећајем из спектра аутизма, као што су обуке родитеља, EAT UP интервенција и метод давања низа јасних инструкција за које постоји висока вероватноћа да ће их испитаник реализовати. Благовремено откривање тешкоћа у храњењу и разлога који до тих тешкоћа доводе, могу омогућити да родитељи и стручњаци заједно дођу до најоптималнијег решења, које неће бити стресно ни по дете ни по мајку, односно особу која о детету брине и која га храни.Healthy eating habits is one of the most important factors in child’s development. These habits are formed in toddlerhood and last a lifetime. Development of these habits in typically developing children undergoes different phases, each bringing new challenges to children and their parents. In children with autism, this process has these identical phases, but additional challenges are met that can last their whole lifetime. When children with autism and their parents are unable to overcome such challenges they grow frustrated and stressed. The aim of this work is to, through available resources, specify and analyze the researches on eating habits and problems in children and adults with autism spectrum disorder, as well as the intervention that can successfully help in dealing with these issues. Google Scholar was used to search for the appropriate research papers. Final results show that the mothers of children with autism report difficulties, most frequently in the children’ avoidance of certain foods due to their texture, packaging, taste or smell, and in children’ choice of foods with poor nutritional qualities. Some of the main causes for these difficulties are sensory experiences of food, problems with gastrointestinal tract, as well as the environment, which can either reinforce of weaken these difficulties. Similar difficulties are also encountered by adults with autism, although some of them manage to overcome them with the help of their families, friends, and individualization. In addition to this, this work depicts a number of interventions that proved successful in the promotion of healthy eating habits in children with autism spectrum disorder, such as appropriate training of parents, EAT UP intervention and giving high-probability instructional sequence. Timely discovery of eating difficulties enable parents and experts to find the most suitable solutions that will not be too stressful for the child or the mother, or the caretaker

Isolation and enrichment of mouse insulin-specific CD4+ T regulatory cells.

Polyclonal T regulatory cells (Treg - CD4+CD25+CD127lowFoxp3+) are used in several protocols for the treatment of type 1 diabetes (T1D), multiple sclerosis and graft-versus host disease in clinical trials. However, general opinion is that autoantigen-specific Treg could be more efficient in autoimmunity suppression due to their direct effect on pathogenic autoantigen-specific effector T cells. This study describes isolation and expansion of insulin-specific Treg in vitro. Insulin-specific Treg are uniformly distributed in lymphoid tissues however their number is extremely low. To enrich the proportion of insulin-specific Treg, pure CD4+ cells were co-cultured with insulin B chain peptide-loaded dendritic cells, isolated from mice that develop T1D spontaneously - NOD mice. Insulin-specific CD4+ cell expansion peaked after 48 h of incubation and was in favour of Treg. These cells were then sorted using insulin peptide-loaded MHC class II tetramers and cultured in vitro for 48 h in the presence of TCR stimulators, TGF-β and IL-2. The proportion of gained insulin-specific cells with T regulatory phenotype (CD4+CD25highCD127lowGITR+FoxP3+) was in average between 93% and 97%. These cells have shown potent in vitro suppressive effect on T effector cells, produced IL-10 and TGF-β and expressed PD-1 and CD39. Further proliferation of these insulin-specific Treg required the presence of dendritic cells, anti-CD3 antibody and IL-2. This study provides new, reproducible experimental design for the enrichment and expansion of insulin-specific Treg that can be used for the cell-based therapy of autoimmunity

Microwave-assisted extraction for the recovery of antioxidants from waste Equisetum arvense

Microwave-assisted extraction was optimised by the response surface methodology in order to enhance the extraction of polyphenols from Equisetum arvense (horsetail). Under the optimal conditions the total polyphenol content in extract reached a concentration of 161.57 mg of gallic acid equivalents per g of extract dry matter. The optimal conditions were reached with 54.5% of ethanol, 45.1 mL/g liquid/solid ratio, the microwave power of 170 Wand 80s extraction time. The antioxidant activity of obtained extract was evaluated by FRAP (ferric reducing antioxidant power) and DPPH (2,2-diphenyl-1-picrylhydrazyl) radical scavenging activity assay. Since, the conditions that favoured maximum polyphenol content in extract were the same as the conditions that favoured maximum antioxidant activity, the polyphenols were identified as the predominant antioxidants in horsetail extracts. When compared to the conventional extraction method (solid liquid extraction for 12 h), our results showed that more polyphenols can be extracted from waste horsetail using microwave extraction and aqueous ethanol, for just 80s. The extracts obtained by optimised extraction procedure exhibit significant antioxidant activity and can be used as a natural source of antioxidants

Indirektna procjena referentnih intervala za parametre štitne žlijezde upotrebom advia centaur XP analizatora

Background: The aim of this study was to determine the reference intervals (RIs) for thyroid stimulating hormone (TSH), free thyroxine (FT4), free triiodothyronine (FT3) and FT3/FT4 ratio using indirect methods. Methods: We analyzed 1256 results TSH, FT4 and FT3 collected from a laboratory information system between 2017 and 2021. All measurements were performed on a Siemens ADVIA Centaur XP analyzer using the chemiluminescent immunoassay. We calculated the values of the 2.5th and 97.5th percentiles as recommended by the IFCC (CLSI C28-A3). Results: The RIs derived for TSH, FT4, FT3 and FT3/FT4 ratio were 0.34–4.10 mIU/L, 11.3–20.6 pmol/L, 3.5–6.32 pmol/L and 0.21–0.47, respectively. We found a significant difference between calculated RIs for the TSH and FT4 and those recommended by the manufacturer. Also, FT3 values were significantly higher in the group younger than 30 years relative to the fourth decade (5.26 vs. 5.02, p=0.005), the fifth decade (5.26 vs. 4.94, p=0.001), the sixth decade (5.26 vs. 4.87, p<0.001), the seventh decade (5.26 vs. 4.79, p<0.001) and the group older than 70 years old (5.26 vs. 4.55, p<0.001). Likewise, we found for TSH values and FT3/FT4 ratio a significant difference (p <0.001) between different age groups. Conclusions: The establishing RIs for the population of the Republic of Srpska were significantly differed from the recommended RIs by the manufacturer for TSH and FT4. Our results encourage other laboratories to develop their own RIs for thyroid parameters by applying CLSI recommendations.Uvod: Cilj ove studije bio je da se odrede referentni intervali (RI) tireotropnog hormona (TSH), slobodnog tiroksina (FT4), slobodnog trijodotironina (FT3) i odnosa FT3/FT4 indirektnom metodom procene referentnih intervala. Metode: Analizirali smo 1256 dobijenih vrednosti TSH, FT4 i FT3 u periodu između 2017. i 2021. godine. Rezultate smo uzeli iz laboratorijskog informacionog sistema. Sva merenja su izvedena na Siemens ADVIA Centaur XP analizatoru pomo}u hemiluminiscentnih imunohemijskih testova. Izračunali smo vrednosti 2,5-og i 97,5-og percentila prema preporuci IFCC-a (CLSI C28-A3). Rezultati: Procenjeni RI za TSH, FT4, FT3 i odnos FT3/FT4 bili su 0,34-4,10 mIU/L; 11,3-20,6 pmol/L; 3,5-6,32 pmol/L i 0,21-0,47. Utvrdili smo značajnu razliku između izračunatih RI za TSH i FT4 i onih koje preporučuje proizvođač. Takođe, vrednosti FT3 bile su značajno ve}e u grupi mlađoj od 30 godina u odnosu na četvrtu deceniju (5,26 vs. 5,02; p = 0,005), petu deceniju (5,26 vs. 4,94; p = 0,001), šestu deceniju (5,26 vs. 4,87; p<0,001), sedmu deceniju (5,26 vs. 4,79; p<0,001) i grupu stariju od 70 godina (5,26 vs. 4,55; p<0,001). Isto tako, za vrednosti TSH i odnos FT3/FT4 pronašli smo značajnu razliku (p <0,001) između različitih dobnih grupa. Zaključak: Procenjene vrednosti referentnih intervala za TSH i FT4 za stanovništvo Republike Srpske značajno su se razlikovale od preporučenih RI od strane proizvođača. Naši rezultati podstiču druge laboratorije da izrade sopstvene RI za parametre štitne žlezde primenom CLSI preporuka

Optimisation of microwave-assisted extraction parameters for antioxidants from waste Achillea millefolium dust

Microwave-assisted extraction of polyphenols and flavonoids from waste Achillea millefolium (yarrow) dust was optimised using the response surface methodology. The influence of the extraction time (13-47 s), ethanol concentration (53-87%), liquid/solid ratio (13-47 mL/g) and microwave power (170 and 340W) was studied. The optimised conditions for the maximal recovery of polyphenols and flavonoids were as follows: 33 s of extraction time, 70% of ethanol concentration, 40 mL/g of liquid/solid ratio and 170W of microwave power. Under the optimal conditions, 237.74 +/- 2.08 mg of gallic acid equivalents per g of extract dry matter of total polyphenols, and 42.95 +/- 1.32 mg of quercetin equivalents per g of extract dry matter of total flavonoids were extracted. The optimal extract strongly reduced the diphenylpicrylhydrazyl radical (IC50 7.89 mu g/mL). The antioxidant activity of the obtained extracts was in correlation to the total polyphenol content in yarrow extracts. Compared to the conventional extractions (solid-liquid extraction (24 h) and maceration (48 h)) microwave-assisted extraction yielded extracts with higher polyphenol and flavonoid content and higher antioxidant activity in very short time (33 s)

Carboxymethyl cellulase production from a Paenibacillus sp.

Cellulases are industrially important enzymes with a potential to convert cellulose into fermentable sugars. Novel bacterial isolate Paenibacillus sp. CKS1 was tested for cellulase activity and the optimal conditions for carboxymethyl cellulase (CMCase) production were determined. Maximum CMCase activity was obtained in the third passage of the bacterial culture after 3 days of incubation at 30 degrees C. Cellobiose and yeast extract was the optimal source of carbon and nitrogen for induction of CMCase activity. In addition, with initial pH 7 of the medium and 40 ml of working volume in 500 ml culture flasks with shaking at 150 rpm, the maximum CMCase activity in a crude culture supernatant reached value of 0.532 +/- 0.006 U/ml. For crude CMCase, optimal temperature was 50 degrees C and optimal pH 4.8, respectively. HPLC analysis confirmed the bacterium is capable to hydrolise CMC to glucose and other soluble sugars

Strain-specific helper T cell profile in the gut-associated lymphoid tissue

C57BL/6, BALB/c and NOD mice are among the most frequently used strains in autoimmunity research. NOD mice spontaneously develop type 1 diabetes (T1D) and they are prone to induction of experimental autoimmune encephalomyelitis (EAE). Both diseases can be routinely induced in C57BL/6 mice, but not in BALB/c mice. Also, C57BL/6 mice are generally considered T helper (Th)1-biased and BALB/c Th2-biased mice. Having in mind increasingly appreciated role of gut associated lymphoid tissue (GALT) cells in autoimmunity, especially in relation to gut Th17 and regulatory T (Treg) cells, our aim was to determine if there are differences in proportion of CD4 + T cell populations in mesenteric lymph nodes and Peyer's p atches of these mouse strains. Lower proportion of Treg was observed in NOD PP, Th2 cells dominated in BALB/c mice in mesenteric lymph nodes (MLN) and Peyer's patches (PP), while Th1 cells prevailed in C57BL/6 MLN. Intradermal immunization of mice with complete Freund's adjuvant resulted in significant difference in Th cell distribution in GALT of NOD mice. Differences were less pronounced in C57BL/6 mice, while GALT of BALB/c mice was almost unresponsive to the immunization. The observed strain- and tissue-dependent changes in Treg proportion after the immunization was probably a consequence of different CCR2 or CCR6-related migration patterns and/or in situ Treg proliferation. In conclusion, NOD, a highly autoimmunity-prone mouse strain, exhibits more profound GALT-related immune response upon immunization compared to the strains that are less prone to autoimmunity.Immunology Letters (2017), 190: 282-28